Who Is Covered by Workers’ Compensation Insurance?
Any bodily injury, illness, or worsening of pre-existing conditions caused by accidents at work are covered by workers’ compensation insurance in the state of Massachusetts. Both documented and undocumented workers are eligible, as well as volunteers and people who work for no pay.
Nearly all employees must be covered by workers' compensation coverage regardless of the number of hours worked or the number of employees a company has. The only exception to this rule is that domestic employees must work 16 hours per week to be covered. Visit mass.gov for more information about workers' compensation insurance requirements and eligible employees.
Injuries must extend past five calendar days in order to qualify for workers’ compensation, but the days do not have to be consecutive. Additionally, workers’ compensation is a no-fault system, meaning you do not need to prove that anyone was negligent. Even if you were at fault, you still get workers’ compensation benefits.
Should I Hire an Attorney for My Workers Compensation Claim?
Our team of qualified attorneys can help you with your claim in many ways. Not only are we well versed in this area of the law, but we are true advocates on your side, fighting for your best interest.
Call our firm today to find out how we can help you especially if:
- You have a preexisting condition
- Your claim has been denied
- Your permanent disability rating is in question
- You have an workers’ compensation hearing
Massachusetts Workers’ Compensation Benefits
If you are injured on the job, your workers’ compensation benefits will include a percentage of your lost wages, which varies based on the injury and is capped at a maximum amount set by the state every year.
Depending on the severity of your injury, you may be eligible for:
- Permanent and total disability: If you become totally and permanently disabled and cannot return to work, you may receive 2/3 of your average weekly wages that you earned before the accident (Massachusetts Law Chapter 152, Section 34).
- Temporary total disability: If you are unable to work for more than five days due to your workplace injury, you may be eligible to receive 60% of your weekly wages for up to three years.
- Partial disability: If you become partially disabled as a result of your injury, meaning that you can return to work but cannot perform at your previous earning capacity, you may receive 60% of your average weekly wages before the injury for up to five years (Massachusetts Law Chapter 152, Section 35).
Other available workers’ compensation benefits cover:
- Medical expenses
- Loss of function
- Scarring
- Death/Survival benefits
- Out-of-pocket expenses (crutches, wheelchairs, etc.)
- Property damage
- Vocational rehabilitation
- Physical therapy
Massachusetts Law Chapter 152, Section 28 states that workers’ compensation benefits will be doubled if the injury is caused by the employers’ “serious and willful misconduct.” This means that if an employer maintains a workplace that is dangerous and violates health and safety codes, you may be eligible for double workers’ compensation benefits.
Massachusetts Law Chapter 152, Section 31 states that a surviving spouse may receive death benefits from the deceased’s employer as long as she remains:
- Living
- Unmarried
- And not fully self-supporting
Can You Receive Workers’ Compensation For Stress?
There are many states that will allow you to seek workers’ compensation for stress-related injuries under certain conditions, however, these cases are extremely difficult to prove because their physical manifestations aren’t as clear-cut as say slipping on a dangerous floor and breaking a bone. In a New Jersey case (Knight v. Audubon Savings Bank) about work-related stress, the court found that since most jobs have some degree of stress, the petitioner must not only show that their stress was abnormal for their sector, but that their workplace environment was truly the cause and that all other external sources were ruled out.
Cases of permanent impairment also hold more weight than those that can be easily fixed if the petitioner is removed from the source of stress. Hiring a work comp lawyer may be in your best interest since he or she can help you figure out if your case is worth pursuing. Feeling stressed out is an unfortunate experience, but for the most part, it’s a natural reaction that most employed people will feel now and again. However, in some rare cases, stress can lead to a chronic manifestation of physical symptoms such as:
- Insomnia
- Lowered immune responses
- Depression
- Stomach pains (such as ulcers)
- Chest pain
- And more
And in even rarer cases, this stress can cause impairment as serious as PTSD. If you suspect your work stress is directly related to a mental health disorder or an inability to function, it may be in your best interest to look into workers’ compensation.
How Do You Prove Work-Related Stress?
1. Document and Report
If you haven’t been keeping documentation of physical or mental manifestations of your stress, start now. And be sure to report these symptoms as soon as you can to your work manager. If you don’t make a record with your manager in a certain amount of time (typically about 30 days), you may not be able to file your claim.
Since stress can build and get gradually worse over time, you still need to report it to your manager ASAP if you think it was work-related. In fact, your report may help the manager develop some strategies for you to lessen your stress levels.
2. Get an Impartial Exam
If you decide to follow through with your claim, you will need to set up an impartial exam with your state workers’ compensation agency. During this exam, a physician will be selected at random from a list to examine your condition. This is an important exam to follow through on since the doctor will be considered unbiased since they were chosen by the state.
3. Develop a Rapport with Your Doctor
Since most stress claims need to be supported with a doctor’s testimony, it is vital that you develop a good working relationship with your physician. Your doctor may use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to establish if you have a long-term impairment. He or she will also test you and give you a “Global Assessment of Functioning” (GAF) rating and a “Whole Person Impairment” (WPI) rating. Not only will you need these diagnostic facts, but you will need to prove that these facts were caused by your job. So you will need to gather the following:
- Performance reviews
- Developmental history
- Documents of personal problems outside of work
- Depositions (e.g. manager and/or co-worker testimony)
- Interviews from friends and family members
Who Is Exempt from Workers' Comp in Massachusetts?
Members of an LLC, partners of an LLP, and sole proprietors of unincorporated businesses are not required by law to carry workers' compensation coverage for themselves, though they may still choose to add this coverage into their policies. Corporate officers who own at least 25% interest in the corporation may also file for an exemption from workers' compensation coverage.
What Happens if An Employer Doesn't Have Workers' Comp Coverage?
If an employer does not have adequate workers' compensation coverage, the Department of Industrial Accidents (DIA) Office of Investigations may issue a stop work order (SWO) requiring them to cease all business activities until proof of coverage is provided.
Minimum fines for a SWO are $100 per day, including weekends and holidays, beginning on the date the SWO was issued. These fines accrue daily until coverage starts and the fine is paid. Employers issued SWOs may also be subject to criminal prosecution and debarment from public contracts for a period of three years.
Contact us online or call (617) 379-0016 for a free and confidential consultation with one of our experienced work injury lawyers. We have offices located in Quincy, Brockton, Plymouth, and Lynnfield.
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